Evaluation of electrocardiogram and echocardiographic characteristics of pre-and post-operation of His bundle pacing: A comprehensive review and meta-analysis.

Objective: Although His bundle pacing (HBP) has shown an improved therapeutic effect than conventional pacing in terms of reducing cardiovascular mortality, the basic characteristics of HBP has not been defined systematically. Therefore, a systematical review and meta-analysis on the HBP characteristics can be timely and favorable. In this study, we aimed to clarify the electrocardiogram and echocardiographic characteristics of the pre- and post-operation of HBP. Methods: Patients with HBP were exclusively included in this study. By evaluating their electrocardiogram characteristics, echocardiographic parameters, and cardiac function, the therapeutic effect of HBP was assessed. Results: A total of 23 studies were included in the analysis. The overall implant success rate for HBP was 83.64%. After HBP treatment, the paced QRS duration dropped from 147.73 +/- 19.46 ms to 116.84 +/- 17.32 ms (p<0.001). Left ventricular ejection fraction (LVEF) increased from 34.87%+/- 9.62% to 46.40%+/- 9.64% (p<0.001), and NYHA functional class improved from 2.90 +/- 0.57 to 1.78 +/- 0.58 within the HBP group (SMD-2.09; 95% CI-2.53,-1.64, p<0.001). Conclusion: HBP can significantly reduce the QRS duration, resulting in improvement of cardiac function in most patients. In addition, this approach is applicable to most patients without limitations.